Please Email the Completed Application Form, with Your Covering Letter, to Or Mail To
Office of Surveyor-General Victoria
You can print this form and fill it in manually or complete it online
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Please email the completed application form, with your covering letter, to
or mail to:
Office of Surveyor-General Victoria
Land Use Victoria
Department of Environment, Land, Water and Planning
GPO Box 527
Melbourne Vic 3001
Personal details
Title: / Family name:Given name/s:
Postal address:
Suburb: / State: / Postcode:
Home telephone: / Mobile:
Email:
Are you an Australian citizen/permanent resident? Yes No
Do you have a current Victorian drivers licence? Yes No
Academic history
Degree currently studying/completed:Major (if applicable):
University/institution:
Average grade for the last academic year (if applicable): / %
Year course commenced:
Expected completion date:
Work experience
If possible, please list two positions you have held that contributed to your experience and skill development.
Company #1:Date employed: / From: (dd/mm/yy) / To: (dd/mm/yy)
Position held:
Main duties:
Contact person or referee: / Phone No:
Company #2:
Dates employed: / From: (dd/mm/yy) / To: (dd/mm/yy)
Position held:
Main duties:
Contact person or referee: / Phone No:
Other skills
Do you have other skills/personal qualities that may assist your application (limit 100 words)?What skills do you hope to develop during your placement (limit 100 words)?
How did you become aware of the Trainee Licensed Surveyor Scheme (you may select more than one)?
Office of Surveyor-General Victoria website
University websiteplease specify
Other websiteplease specify
Newspaper/publicationplease specify
University careers fairUniversity information session
Word-of-mouthOther
Statement of authenticity
The information I have provided in this application form is true and correct at the time of submission.
Yes No
Privacy statement
Any personal information about you or a third party in your correspondence will be protected under the provisions of the Information Privacy Act 2000 (the Act). Your information is being collected by Office of Surveyor-General Victoria, which is part of the Department of Environment, Land, Water and Planning. The department is committed to and adopts the Information Privacy Principles (IPPs) set out in the Act. We have systems and procedures in place to protect your privacy whenever we collect, use, and store or disclose your personal information.
The information collected from you in this application is for the primary purpose of recruitment with Office of Surveyor-General Victoria. The information will only be used or disclosed to appropriate ministerial, statutory authority or departmental staff in regard to the purpose for which it was provided, unless required or authorised by law.
Should your application be unsuccessful we are required by law to retain it for a period of six months after the completion of the selection process. Subject to the Public Records Act 1973, we will destroy the documents you provided and any copies or other records we made. If you fail to provide information or the information you do provide is insufficient or inaccurate, Office of Surveyor-General Victoria will be restricted in its ability to assess your suitability for employment and may not be able to offer you an ongoing position.
You are entitled to gain access to information about you held by the department. If at any time your details change or you would like to update or access any personal information we have collected about you please contact the Manager Privacy, Office of Surveyor-General Victoria, Department of Environment, Land, Water and Planning.
Signature:Date:(if application is being sent as hardcopy)
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